EFFECT OF INDOOR SLACKLINING EXERCISES ON PAIN, FUNCTIONAL PERFORMANCE AND BALANCE AMONG PATIENTS WITH GRADE I OSTEOARTHRITIS OF KNEE– A RANDOMIZED CONTROLLED TRIAL

Abstract

Background: Knee osteoarthritis (OA) is one of the most prevalent musculoskeletal disorders affecting adults and is characterized by pain, reduced functional performance, decreased balance, and limitations in activities of daily living. Conventional physiotherapy interventions are commonly used to manage symptoms and improve function; however, novel exercise approaches that enhance neuromuscular control and postural stability may provide additional benefits. Indoor slacklining is a dynamic balance-training exercise that challenges proprioception, coordination, and lower-limb muscle activation. Limited evidence exists regarding its effectiveness in individuals with Grade I knee osteoarthritis. Objective: To study the effect of indoor slacklining exercises on pain, functional performance, and balance in patients with Grade I knee osteoarthritis. Methods: A randomized controlled trial was conducted after obtaining approval from the Institutional Ethics Committee. The purpose and procedure of the study were explained to all participants, and written informed consent was obtained. A total of 42 participants diagnosed with Grade I knee osteoarthritis based on clinical examination and radiographic findings were recruited. Subjects were screened according to predefined inclusion and exclusion criteria and were randomly allocated into experimental and control groups using a computerized random number sequence generator. Allocation concealment was ensured through the envelope method, and blinding was maintained for both participants and physiotherapists. Baseline assessments included the Numeric Pain Rating Scale (NPRS), Y Balance Test, and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). The experimental group received an indoor slacklining exercise protocol, while the control group received standard conventional physiotherapy for 4 weeks. During the intervention period, four participants dropped out (two from each group). Outcome measures were reassessed after 4 weeks, and data were analyzed using appropriate statistical methods. The study adhered to CONSORT guidelines. Results: The experimental group demonstrated significantly greater improvements than the control group. Indoor slacklining exercises resulted in a statistically significant reduction in pain as measured by NPRS scores. Balance performance, assessed using the Y Balance Test, showed highly significant improvement in the experimental group. Additionally, WOMAC scores decreased significantly, indicating superior improvements in functional performance compared with conventional physiotherapy. Conclusion: Indoor slacklining exercises are effective in reducing pain and enhancing functional performance and balance in patients with Grade I knee osteoarthritis. Therefore, indoor slacklining may be considered a valuable adjunct to conventional physiotherapy rehabilitation programs for individuals with early-stage knee osteoarthritis. Keywords: Knee Osteoarthritis; Indoor Slacklining; Balance Training; Functional Performance; Pain; Y Balance Test; WOMAC.